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目的:探讨如何提高甲状腺微小癌(TMC)的临床诊断率。方法:回顾性分析2000-01-2009-12期间经手术和病理检查证实的73例TMC患者的诊断资料,将其分为A、B组,A组为可触及区域淋巴结和(或)甲状腺质硬小结节,共21例;B组为不能触及区域淋巴结和(或)甲状腺质硬小结节,共52例,并对诊断资料进行统计分析。结果:术前及术中明确诊断者有53例,诊断率为73%(53/73),其中A组18例,诊断率为86%(18/21);B组35例,诊断率为67%(35/52);各种辅助检查及术中探查对提高TMC的诊断率相比较差异有统计学意义(P<0.05)。结论:TMC临床漏诊率较高,若主治医师能足够重视,通过术前仔细触诊、相应的辅助检查等有助于提高其临床诊断率。
Objective: To explore how to improve the clinical diagnosis rate of thyroid microcarcinoma (TMC). Methods: The diagnostic data of 73 patients with TMC confirmed by operation and pathology from 2000 to 2009 were retrospectively analyzed. They were divided into group A and group B. Group A was palpable with regional lymph nodes and / or thyroid gland Hard nodules, a total of 21 cases; group B can not touch the regional lymph nodes and (or) thyroid hard nodules, a total of 52 cases, and the diagnostic data for statistical analysis. Results: 53 cases were diagnosed preoperatively and intraoperatively, the diagnostic rate was 73% (53/73), of which 18 cases were in group A, the diagnostic rate was 86% (18/21); 35 cases in group B, the diagnostic rate was 67% (35/52) respectively. There was significant difference between various auxiliary examinations and intraoperative exploration in improving the diagnostic rate of TMC (P <0.05). Conclusion: The rate of missed diagnosis of TMC is high. If the attending physician can pay enough attention to it, it can help to improve the clinical diagnosis rate by careful palpation and corresponding auxiliary examination before operation.